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General NPI Number Information
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NPI Number | 1073412474
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Entity Type | Organization
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Legal Business Name | NYC PA SERVICES PC
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Dates
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Enumeration Date | 11/02/2026
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Last Update Date | 11/02/2026
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Provider Practice Location Address
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Address Line | 13732 70TH RD
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City | FLUSHING
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State | NY
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Zip | 11367-1930
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Country | US
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Telephone | 718-877-5263
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Fax |
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Provider Business Mailing Address
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Address Line | 13732 70TH RD
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City | FLUSHING
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State | NY
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Zip | 11367-1930
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Country | US
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Telephone | 718-877-5263
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAFAEL AVEZBAKIYEV
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Credential |
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Telephone | 718-877-5263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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